U.S. Water News Online
HONG KONG -- Leaky sewage pipes and bathroom ventilation fans carried contaminated droplets through a Hong Kong apartment complex, causing one of the world's worst outbreaks of SARS, World Health Organization investigators said.
Also, Taiwan's health chief resigned to take responsibility for the worsening SARS crisis that has shut two hospitals in the capital Taipei. The government appointed a highly respected epidemiologist to replace him.
Twu Shiing-Jer's resignation came as 10 new cases of severe acute respiratory syndrome were reported in Taiwan, along with three deaths -- two of them the first doctors there to die of SARS. The disease has now made 274 people ill and killed 37 in Taiwan.
Worldwide, at least 613 have died and 7,700 been infected since SARS emerged in southern China in November.
In Hong Kong alone, SARS has infected 1,706 people and killed 238. More than 300 people contracted the illness at the Amoy Gardens apartment complex in late March, and 35 people died. The speed of the infection amazed health experts, who at the time believed the disease was spread mainly by person-to-person contact.
A report by WHO investigators blamed an ``unlucky'' combination of circumstances -- a patient with diarrhea, seeping pipes and drafty air shafts.
``It's just an accumulation of events,'' team leader Dr. Heinz Feldmann told a news conference. Feldmann said there was no way to guarantee against a repeat but that another such outbreak seems ``unlikely.''
When investigators went to Amoy Gardens to collect samples, they found no live coronaviruses -- the family of virus believed to cause severe acute respiratory syndrome -- and no remaining genetic material from the virus, Feldmann said. The WHO's findings largely confirm an earlier report by Hong Kong officials.
The WHO team is still testing samples collected from another housing development, the Tung Tau Estate, that suffered a minor outbreak. Feldmann said preliminary findings showed the sewage system did not appear to be the cause.
The disease was brought to the Block E building of Amoy Gardens by a sick man visiting his brother, the Hong Kong government said earlier. The man had diarrhea and others who caught SARS in the building also developed diarrhea, spreading the virus through the sewage system.
Droplets containing the virus apparently got into some apartment units through dried-out drain traps -- the U-shaped pipes that are supposed to keep gases and waste from coming up back up. Bathroom exhaust fans sucked droplets into apartments, the WHO report said.
The fans could also have moved contaminated droplets into a light and air shaft, where wind carried them into other apartments through open windows.
Feldmann said there was no evidence the virus was airborne, but small droplets can travel up to five feet through the air, perhaps further with a strong wind.
A pipe breakage shut down the water used to flush toilets at one point, possibly trapping some infected sewage and allowing the virus to multiply, WHO said.
Feldmann said an earlier outbreak of SARS at Hong Kong's Metropole Hotel apparently was caused by close person-to-person contact. An ill mainland Chinese medical professor visiting the Metropole in February infected 16 people who spent time on the ninth floor. They spread SARS throughout Hong Kong and to Vietnam, Canada and Singapore, which also saw fatal outbreaks.
In China, officials Friday started punishing people for violating SARS-related restrictions. A woman received a one-year sentence for leading protesters who vandalized a building being turned into a quarantine center.
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